Should We Hold the (Germ) Line?

President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research, Splicing Life (Washington, D.C.: United States Government Printing Office, 1982).

Capron Alexander Morgan , “The Impact of the Report, Splicing Life,” Human Gene Therapy, 1 (1990): At 70 (emphasis added).

The somatic/germ cell distinction will be important throughout this essay. Germ cells are those involved in reproduction (ova and sperm); alterations of germ cells are passed on to future generations. Somatic cells are all of the other cells in the body; alterations of them are not passed on.

Wivel Nelson A. Walters LeRoy , “Germ-Line Gene Modification and Disease Prevention: Some Medical and Ethical Perspectives,” Science, 262 (1993): At 537. For a more tentative (and earlier) call for the same, see Walters LeRoy , “Human Gene Therapy: Ethics and Public Policy,” Human Gene Therapy, 2 (1991): At 118.

“Summary of the December 1–2, 1994 Recombinant DNA Advisory Committee (RAC) Meeting”: “The RAC unanimously recommended the establishment of a working group to examine the ethical issues involving in utero gene therapy; however, since the issue of germ-line gene therapy and transmission is inseparable from the issue of in utero therapy, the working group should analyze both issues and their relationship to each other.”

Fletcher John C. French Anderson W. , “Germ-Line Gene Therapy: A New Stage of Debate,” Law, Medicine & Health Care, 20 (1992): 26–39; Zimmerman Burke K. , “Human Germ-Line Therapy: The Case for Its Development and Use,” Journal of Medicine and Philosophy, 16 (1991): 593–612; Cook-Deegan Robert M. , “Germ-Line Therapy: Keep the Window Open a Crack,” Politics and the Life Sciences, 3 (1994): 217–20; and Munson Ronald Davis Laurence H. , “Germ-Line Gene Therapy and the Medical Imperative,” Kennedy Institute of Ethics Journal, 2 (1992): 137–58.

See President's Commission, supra note 1, at 56; Motulsky Arno G. , “Impact of Genetic Manipulation on Society and Medicine,” Science, 219 (1983): At 135; and Wolff Jon A. Lederberg Joshua , “An Early History of Gene Transfer and Therapy,” Human Gene Therapy, 5 (1994): At 470.

Eric Juengst names five of the other most used arguments for germ-line alteration: (1) medical utility; (2) medical necessity; (3) prophylactic efficiency; (4) respect for parental autonomy; and (5) scientific freedom (see Juengst Eric T. , “Germ-Line Gene Therapy. Back to Basics,” Journal of Medicine and Philosophy, 6 (1991): At 589–90).

Silverman Paul H. , Associate Chancellor, University of California-Irvine, has suggested this line of argument in an unpublished manuscript, “Human Germ-Line Gene Alteration: An Approaching Reality?.”

“Afterword: A Talk with the Author,” in Kundera Milan , The Book of Laughter and Forgetting, trans. Heim Michael Henry (New York: Penguin Books, 1981): At 229.

In addition to the slippery slope to enhancement argument, Juengst names four others: (1) scientific uncertainty and clinical risks; (2) consent of future generations; (3) allocation of resources; and (4) integrity of genetic patrimony. See Juengst , supra note 8, at 590.

For a recent slippery slope argument, see Gardner William , “Can Human Genetic Enhancement Be Prohibited?,” Journal of Medicine and Philosophy, 20 (1995): 65–84.

Danks David M. , “Germ-Line Gene Therapy: No Place in Treatment of Genetic Disease,” Human Gene Therapy, 5 (1994): 151–52.

deWachter Maurice A. M. , “Ethical Aspects of Human Germ-Line Therapy,” Bioethics, 7 (1993): At 170.

Human Gene Therapy Subcommittee, NIH Recombinant DNA Advisory Committee, “The Revised ‘Points to Consider’ Document,” Human Gene Therapy, 1 (1990): At 95.

Recombinant DNA Advisory Committee, “Selected Minutes from October 6, 1989 RAC Meeting,” Human Gene Therapy, 1 (1990): At 187.

For the application of this argument to the germ-line alteration question, see Lappé Marc , “Ethical Issues in Manipulating the Human Germ Line,” Journal of Medicine and Philosophy, 16 (1991): At 629–30.

See Human Gene Therapy Subcommittee, supra note 15, at 96.

See Silverman , supra note 9.

Fletcher John C. , “Evolution of Ethical Debate about Human Gene Therapy,” Human Gene Therapy, 1 (1990): 55–68; Berger Edward M. Gert Bernard M. , “Genetic Disorders and the Ethical Status of Germ-Line Gene Therapy,” Journal of Medicine and Philosophy, 16 (1991): 667–83; and Moseley Ray , “Commentary: Maintaining the Somatic/Germ-Line Distinction: Some Ethical Drawbacks,” Journal of Medicine and Philosophy, 16 (1991): 641–47.

Harris John , Wonderwoman and Superman: The Ethics of Human Biotechnology (Oxford: Oxford University Press, 1992); Resnick David , “Debunking the Slippery Slope Argument against Human Germ-Line Gene Therapy,” Journal of Medicine and Philosophy, 19 (1994): 23–40; and Miller Henry I. , “Gene Therapy for Enhancement,” The Lancet, 344 (1994): 316–17.

See Cook-Deegan , supra note 6, at 220. For example, on “cheap moralizing,” see Mauron Alex , “Germ-Line Angst and Uncertain Futures,” Politics and the Life Sciences, 13 (1994): At 231.

Neel James V. , “Germ-Line Gene Therapy: Another View,” Human Gene Therapy, 4 (1993): At 127.

Anderson Walter Truett , To Govern Evolution (Orlando: Harcourt Brace Jovanovich, 1987).